Healthcare Provider Details

I. General information

NPI: 1235946351
Provider Name (Legal Business Name): WESTBURY EXPRESS PHARMACY OF OKC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S MORGAN RD STE A
OKLAHOMA CITY OK
73128-7027
US

IV. Provider business mailing address

1096 COUNTY STREET 2840
POCASSET OK
73079-8220
US

V. Phone/Fax

Practice location:
  • Phone: 405-914-2385
  • Fax: 405-914-2386
Mailing address:
  • Phone: 405-914-2385
  • Fax: 405-914-2386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOEL DAVENPORT
Title or Position: OWNER
Credential: PHARMD
Phone: 405-248-8455